Int J Stomatol

Int J Stomatol ›› 2025, Vol. 52 ›› Issue (3): 333-340.doi: 10.7518/gjkq.2025049

• Periodontal cases • Previous Articles    

Treatment of gingival papilla loss with gingival recession in orthodontic patients with stage Ⅲ grade C periodontitis: a case report

Meilin Zhao(),Yiqiong Zhao,Jiao Huang()   

  1. Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
  • Received:2024-03-19 Revised:2025-01-22 Online:2025-05-01 Published:2025-04-30
  • Contact: Jiao Huang E-mail:zhaomeilin@cqmu.edu.cn;huangjiao@hospital.cqmu.edu.cn
  • Supported by:
    Chongqing Municipal Science and Technology Bureau Project(CSTB2022BSXM-JCX0047)

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Abstract:

Comprehensive periodontal nonsurgical treatment and orthodontic treatment can improve the oral health, function, and aesthetics of patients with periodontitis. For patients with severe periodontitis, aesthetic problems, such as gingival recession and gingival papillary defects, may occur after periodontal system treatment, requiring personalized multidisciplinary collaborative treatment. This article reports a case of a patient with stage Ⅲ grade C periodontitis who underwent periodontal nonsurgical, simple flap, and orthodontic treatments in the anterior tooth area and labial-gingival retraction and gingival papillary defect repair in the anterior teeth. Preoperative X-ray measurement and diagnostic mock-up analysis revealed that the distance from the contact point to the alveolar ridge crest could be reduced to less than or equal to 5 mm and an ideal aesthetic effect of the dental crown could be achieved. A T-shaped connective tissue flap and lip coronal-positioned flap were designed to reconstruct the gingival papilla and improve the lip gingival recession. Composite resin veneers were used to lower the contact point position and repair black triangles. Remarkable improvement in clinical attachment level, ideal root coverage effect, and good gingival papilla morphology were achieved two years after surgery. These changes improved the prognosis of the affected teeth and facilitated the long-term maintenance of aesthetic effects. Long-term cli-nical outcomes require further clinical observation.

Key words: black triangle, periodontitis, orthodontics, open flap debridement, gingival recession, interdental papilla reconstruction, root coverage, veneer

CLC Number: 

  • R781.4

TrendMD: 

Fig 1

Intraoral photographs of the patient before surgery"

Fig 2

Initial periodontal chart"

Fig 3

Preoperative examination and treatment design"

Fig 4

Intraoral photographs during surgery"

Fig 5

Intraoral photographs at 2 weeks, 2 months, 3 months, and 12 months after surgery"

Fig 6

Periodontal chart at 12 months after surgery"

Fig 7

Intraoral photographs at 15 months after surgery"

Fig 8

Periapical radiography after surgery"

Fig 9

Intraoral photographs at 18 months after surgery"

Fig 10

Intraoral photographs at 24 months after surgery"

Tab 1

Comparison of clinical indicators before and 24 months after surgery for tooth 21, 22"

时间龈乳头缺陷牙龈退缩/mm黑三角大小/mm2邻面PD/mmCAL/mm
术前Ⅱ类36.33~45~6
术后24个月Ⅰ类10.62~33~4
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